Individual
MICAH JARED BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, MAT
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1087
HI
225700000X
Massage Therapist
12759
HI
Other
Enumeration date
05/26/2017
Last updated
09/02/2021
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